When is removal needed, and what happens at your assessment?
We do not remove teeth for the sake of it. If your wisdom tooth is impacted but you have no pain, infection or disease, your dentist can simply keep an eye on it at your regular check ups. This is exactly what the national guidance supports. If you are unsure, we are happy to give a second opinion.
At your assessment we talk through your symptoms and examine your mouth. An image is usually needed to see the position of the tooth, its roots and its relationship to nearby structures such as the nerve in your lower jaw. Our fee list shows a digital panoramic image at £75 and small images at £12.
A 3D CBCT scan, priced at £175 per arch, may be recommended in selected cases. The Royal College of Surgeons guidance says CBCT should not be used routinely, but can be considered when standard images show the tooth is very close to the jaw nerve and the result would change the treatment plan. You can read how we use CBCT scans for planning.
You will leave knowing whether removal is advisable, what type of extraction is likely, which anaesthetic options suit you, and how much it will cost.
Why wisdom teeth cause problems, and the types of extraction
Wisdom teeth are the last to arrive, and by then there is often little room left. A tooth can come through only partly, lie at an angle, or stay buried in the gum or jawbone, which dentists call impacted. A partly erupted tooth can trap food and bacteria under the gum, which is what leads to pericoronitis. A tooth leaning against its neighbour can be hard to clean, which may lead to decay. Not every impacted tooth causes trouble, and many are never noticed.
Simple extraction. If a tooth has fully come through, it can often be removed like any other tooth. The standard process is explained under tooth extraction.
Surgical extraction. If a tooth is impacted, partly through the gum or has curved roots, the gum may need to be opened and a little bone removed. The tooth may be divided into sections for easier removal, and the area is closed with dissolvable stitches. We cover this in more detail in oral surgery.
Referral for complex cases. Where a lower wisdom tooth lies very close to a nerve, the Oral Health Foundation notes that you may be referred to a specialist. We would explain why and talk you through the options.
Anaesthesia and sedation
Wisdom teeth are usually taken out under local anaesthetic, so the area is numb and you stay awake. You may feel pressure and movement but should not feel pain. The NHS says the procedure should take no more than 40 minutes.
If you are anxious about dental treatment, or your case is more involved, intravenous sedation is an option that helps you feel relaxed. After sedation, the NHS advises not driving for 24 hours, and after a general anaesthetic, 48 hours. How it works is explained in our information on dental sedation.
Risks and complications
Every surgical procedure has risks, and we would rather you heard them from us. The main ones are:
- Dry socket. This is a painful condition in which the blood clot in the socket is lost or does not form. The Royal College of Surgeons guidance describes it as the most common complication, reported in around 5 percent of routine extractions and up to almost 30 percent after surgical removal of wisdom teeth. Not smoking and following your aftercare advice lower the risk.
- Infection. This may need antibiotics, according to the NHS.
- Bleeding. A small amount of oozing is normal. Firm pressure on a clean pad for at least 10 minutes usually stops it.
- Nerve changes. A leaflet from King's College Hospital says about one in 10 people have tingling or numbness lasting several weeks after removal of impacted wisdom teeth, and fewer than one in 100 have problems lasting more than a year. The NHS says numbness of the tongue, lip or chin usually improves over weeks or months. Your dentist will tell you how close your tooth is to the nerve.
We will talk through your individual risks at your consultation and answer every question.
Recovery and aftercare: what to expect, day by day
- First day: rest. Bite gently on the gauze if you bleed. Avoid hot drinks, smoking, drinking through a straw, poking the area, and rinsing vigorously, so the blood clot in the socket can protect healing.
- Days one to three: swelling and discomfort are usually at their worst for around three days. Take pain relief as directed and use a cold pack on the cheek. From the day after surgery, warm salt water rinses are recommended.
- First week: eat soft food and avoid hard or small foods that could lodge in the socket. Avoid smoking and alcohol. Many people return to normal activity the day after, though more complex surgery or a general anaesthetic can mean one to three days off.
- Up to two weeks: soreness and bruising may last this long. Dissolvable stitches disappear in around two weeks and do not need removing.
Contact us straight away if you have bleeding that will not stop, severe or worsening pain or swelling, pain with a bad taste, a fever or you feel unwell. Numbness or tingling in your lip or tongue in the days after surgery should also be reported. If you need urgent help with an impacted wisdom tooth, we explain how to reach us.
Preparing for your appointment, and questions to ask
- Eat normally beforehand unless you are having sedation, in which case we will give you specific instructions.
- If you are having sedation, arrange for someone to take you home and stay with you, and do not plan to drive.
- Let us know about any medicines, allergies or medical conditions, and tell us if you smoke, as this affects healing.
- Wear comfortable clothing, plan a quiet day afterwards, and stock up on soft food such as soup, yoghurt and scrambled eggs.
Before you decide, ask: is this tooth causing a problem now, or could it be monitored? What type of extraction do you expect, and why? How close is the tooth to the nerve? What are the anaesthetic or sedation options and what do they cost? What are the risks in my case? How much time should I take off? Who do I call if I am worried afterwards? If you would like a second opinion on a recommendation you have been given elsewhere, we are happy to help.
Why have your wisdom teeth treated at Maida Smiles?
We are a private practice on Sutherland Avenue, two minutes from Maida Vale tube, open until 8pm on Tuesdays, Wednesdays and Thursdays. You will be told what is recommended, why, and what the alternatives are, in writing, before any treatment starts.
Wisdom teeth removal FAQs
